Evaluating a Water Safety Plan Intervention in Ghana
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Water Safety Plans.
- Who it may be relevant to
- Registry conditions: Water Quality, Water Treatment, Diarrhea. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Ghana
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
The objective of this study is to evaluate the effects of water safety plans (WSPs) in rural Ghana. The investigators aim to evaluate the effects of WSPs on water supply system infrastructure, water availability and reliability, water quality, consumer perceptions, water service provider management and financial sustainability, climate resilience, equity, and consumer health.
Detailed description
Much of the global population is exposed to contaminated drinking water. In piped systems, it is often easier to mitigate at the water supplier level where it can be centrally managed. A water safety plan (WSP) is a holistic tool for proactively ensuring the safety of drinking water supplies from source to tap, and the World Health Organization (WHO) recommends this systematic risk assessment and preventive management approach for water systems.
While application of WSPs has spread, systematic evidence for their implementation and effectiveness in improving water quality and health is limited, particularly in low-resource settings.
The objective of this study is to evaluate the impact of WSPs on water supply system infrastructure, water availability and reliability, water quality, consumer perceptions, water service provider management and financial sustainability, climate resilience, equity, and consumer health. The investigators will use a randomized controlled trial across 92 piped water supply systems serving small towns and rural areas in Ghana to test the effectiveness of WSPs. The investigators will collect data at baseline before the intervention is implemented, and at endline approximately 2 years after implementation begins. The investigators will also conduct a process evaluation of the WSP implementation quality.
Interventions
- Other Water Safety Plans
Water safety plans will be implemented at the water system level as a holistic tool for ensuring the safety of drinking water supplies from source to tap. World Health Organization guidance will be followed for implementation and recommended water safety planning steps will be followed such as assembling a WSP Team, describing the water supply, hazard identification and risk assessment, developing and implementing an incremental improvement plan, monitoring control measures to verify the effecti
Primary outcome measures
- Free chlorine residue in water at point of collection (water quality impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
- E. coli in water at point of collection (water quality impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
- Total coliform in water at point of collection (water quality impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
- Turbidity of water at point of collection (water quality impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
- Reliability/availability of water (water supply impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
Secondary outcome measures (12)
- Consumer satisfaction (consumer perception impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
- Household use of enrolled piped water system for drinking (consumer perception impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
- Households perceive water quality issues with piped water system (consumer perception impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
- Number of complaints (consumer perception impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
- Prevalence of diarrhea (health impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
- Blood in stool (health impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
- Prevalence of severe diarrhea (health impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
- Prevalence of acute respiratory infection (health impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
- Number of clinic visits for water-related illness (health impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
- E. coli in stored water at point of consumption (water quality impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
- Total coliform in stored water at point of consumption (water quality impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
- Free chlorine residue in stored water at point of consumption (water quality impacts) [Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)]
Eligibility criteria
Eligibility to receive the intervention was determined by water system criteria:
Inclusion criteria
- Water systems must be operated by a partnering private, non-profit water supplier.
- Water systems must be functional during baseline data collection.
To be eligible to participate in household surveys or focus group discussions, participants need to be at least 18 years of age and a customer of a eligible water system. To be eligible to participate in health care facility interviews, participants must be at least 18 years of age and work at a health care facility that serves community members using the included water system.
Exclusion criteria
- Water systems did not meet both of the above inclusion criteria.
- Water systems had already implemented a water safety plan.
- Water systems were involved in another ongoing research trial with similar expected outcomes.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Other
Study locations
Ghana · 1 center
- The Aquaya Institute — Accra
Identifiers
NCT: NCT07317167 · WSP Evaluation